Publications by authors named "Biggya L Sapkota"
Article Synopsis
- The study investigated the impact of endovascular therapy (EVT) on cognitive outcomes following a large vessel occlusion stroke, using data from the ESCAPE trial.
- Cognitive assessments were performed 90 days post-stroke and included various tests to evaluate memory and cognitive function, with results indicating that EVT significantly improved cognitive outcomes across all tests.
- Findings showed that EVT was associated with better cognitive performance (higher odds ratios for favorable outcomes), and both final infarct volume and cognitive function had notable correlations, suggesting that both factors influence recovery.
Introduction: Endovascular treatment of acute ischemic stroke is more effective when performed quickly. In this report, we describe quality interventions to ensure fast endovascular treatment times in the ESCAPE (Endovascular Treatment for Small Core and Anterior circulation Proximal Occlusion with Emphasis on Minimizing CT to Recanalization Times) trial.
Methods: An "audit and feedback" intervention using webinar and letter was used to improve treatment time over the course of the trial.
Importance: Endovascular thrombectomy with second-generation devices is beneficial for patients with ischemic stroke due to intracranial large-vessel occlusions. Delineation of the association of treatment time with outcomes would help to guide implementation.
Objective: To characterize the period in which endovascular thrombectomy is associated with benefit, and the extent to which treatment delay is related to functional outcomes, mortality, and symptomatic intracranial hemorrhage.
Background And Purpose: The goal of reperfusion therapy in acute ischemic stroke is to limit brain infarction. The objective of this study was to investigate whether the beneficial effect of endovascular treatment on functional outcome could be explained by a reduction in post-treatment infarct volume.
Methods: The Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE) trial was a multicenter randomized open-label trial with blinded outcome evaluation.
Hashimoto encephalopathy (HE) is a rare autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased antithyroid antibody levels. Neurosarcoidosis is also a rare entity that occurs in less than 5% of patients with systemic sarcoidosis. Neurosarcoidosis usually presents with cranial neuropathies, myelopathy, or new-onset seizure.
View Article and Find Full Text PDFBackground: Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of patients die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment in addition to standard care in patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation.
Methods: We randomly assigned participants to receive standard care (control group) or standard care plus endovascular treatment with the use of available thrombectomy devices (intervention group).
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA.
View Article and Find Full Text PDFPurpose Of Review: : Risk factor modification plays an important role in recurrent stroke prevention. These modifiable risk factors tend to cluster in stroke patients, but for a significant subgroup the only identifiable risk factor is high blood pressure or chronic hypertension. This article reviews the current evidence for management of blood pressure in secondary stroke prevention.
View Article and Find Full Text PDFObjective: To determine the predictive value of discharge destination as a surrogate for defining unfavorable outcome at 3- and 12-months poststroke.
Design: Analysis of the prospectively collected data from a randomized, placebo-controlled trial in patients with ischemic stroke presenting within 3 hours of symptom onset.
Setting: Post hoc analysis of patients recruited in a clinical trial.